Does family medicine reduce household health expenditures: evidence from Türkiye

TİRGİL A., Altun A., Yanikkaya H.

Journal of Public Health Policy, vol.44, no.1, pp.75-89, 2023 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 44 Issue: 1
  • Publication Date: 2023
  • Doi Number: 10.1057/s41271-022-00391-5
  • Journal Name: Journal of Public Health Policy
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus, Academic Search Premier, ASSIA, PASCAL, Periodicals Index Online, CAB Abstracts, CINAHL, EMBASE, Environment Index, Index Islamicus, MEDLINE, PAIS International, Political Science Complete, Public Affairs Index, Social services abstracts, Sociological abstracts, Veterinary Science Database, Worldwide Political Science Abstracts
  • Page Numbers: pp.75-89
  • Keywords: Family medicine, Household health expenditures, Primary healthcare, Out-of-pocket healthcare expenditures
  • Ankara Yıldırım Beyazıt University Affiliated: Yes


© 2023, The Author(s), under exclusive licence to Springer Nature Limited.Türkiye introduced a family medicine-centered primary healthcare model in 2005 as part of the Health Transformation Program, which aimed to reduce household healthcare expenditures, improve access to health services, and reduce the crowding-out effect in first-stage hospital institutions. We investigate the impact of the family medicine program on household healthcare expenditures in Türkiye, focusing on doctor visits, medication prescriptions, and hospitalization expenditures. Using data from a large representative household survey, we employ a difference-in-differences approach combined with the entropy-balancing matching technique. Our robust findings show that living in a province exposed to the family medicine program reduced household doctor visit expenditures by over 40 percent. We also find a significant negative association between the family medicine program and expenditures regarding doctor visits and medication prescriptions in the long run. Greater efforts are now needed to ensure the quality of services offered by family health centers, such as improving the doctor-to-patient ratio.